In normal wound-healing or sore-healing processes, the abundant vascular network is regenerated in the wound or the sore during the maturing phase and the collagen fibres collect in large bundles. Sometimes this maturing process fails to occur, so that granulation tissue remains beneath the covering epithelium for a relatively long period of time and may even develop and become enlarged. This is the clinical nature of a hypertrophic scar.
A hypertrophic scar is a raised, red and itching enlargement. The scar may be tender to the touch and to other external pressure and can form on every afflicted part of the body, although it is most prevalent after burn injuries and as a result of wounds across the breastbone and in the shoulder regions.
Hypertrophic scars often remain for a very long time, sometimes until the person concerned dies. In the case of adults, the hypertrophic scar will normally transform to a typical soft and pale scar after a year or so. In addition to itching and being relatively unsightly, hypertrophic scars in the region of joints can also impair joint mobility.
There is at present no quick and effective remedy for hypertrophic scars. The maturing phase can be accelerated in some instances, by injecting glucocorticoid into the scar formations.
It has been discovered in recent years that the regeneration rate of hypertrophic scars can be increased by applying silicone-gel plates to the scars. The mechanism by which the silicone-gel interacts with such scars has not been established, however. A number of products are available commercially for this purpose, for instance such products as Dow Corning Silastic Sheeting (Dow Corning), Cica-Care (Smith & Nephew), Epi-Derm (Biodermis), Nagosil (Nagor), among others. These products have the form of molded silicone-gel plates having a thickness of 2-4 mm. In treating hypertrophic scars, these plates are placed over the scars and are worn for a relatively long period of time, often from three to twelve months, until the scars either have decreased or have regenerated.
The known silicone plates are relatively rigid and after having been placed over the scar have insufficient adhesion force to remain securely in position without some form of assistance. Consequently, it is necessary to secure the plates against the skin with the aid of a securing stocking, bandage, self-adhesive tape or some like means.
This makes the known silicone plates difficult to handle and to feel uncomfortable by the patients concerned. Since the patient needs to wear such plates continuously for a long period of time, due to the fact that scar regeneration is a slow process, optimization of patient comfort is of the greatest concern. A product which is difficult to handle and is felt to be uncomfortable can lower the patient's motivation to undergo the treatment.